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Billing news

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Modified: 6/13/2019
Submitted in response to common billing issue relating to improper or insufficient documentation for tetanus vaccinations
Data indicates that many providers are not submitting proper diagnosis codes to support the medical necessity for tetanus vaccinations.
Modified: 6/12/2019
Change request 11181 provides billing instructions for hospital Part B inpatient services. Make sure your billing staffs are aware of these instructions. [MM11181]
Modified: 6/8/2019
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2019 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM11025]
Modified: 6/6/2019
The Centers for Medicare & Medicaid Services (CMS) has provided information to Medicare administrative contractors (MACs) regarding outreach to clearinghouses, third-party billers, providers and other users regarding CWF provider inquiries for Medicare beneficiary eligibility data.
Modified: 5/31/2019
First Coast would like to ensure providers performing biopsy services understand how to properly bill and code for these procedures. Recent data indicates improper billing so we want to provide clarification of top issues we identified.
Modified: 5/16/2019
Please review this article if you submit Medicare Part B paper claim forms. First Coast is implementing instructions from CMS that will impact how many claim lines you are able to submit.
Modified: 5/9/2019
Most services billed to Medicare must reflect the exact date the service was performed for or provided to the patient. This article discusses situations where there have been questions from the provider community.
Modified: 4/17/2019
This information outlines the process for the 935 recoupment.
Modified: 4/10/2019
To determine if a claim was medically reviewed, providers should look at certain fields on the claim screen. [Provider Outreach and Education]
Modified: 4/4/2019
The Multi-Carrier System (MCS) currently requires modifiers 59, XE, XS, XP, and XU be appended to the column two code to bypass a procedure-to-procedure (PTP) edit. Effective July 1, 2019, Medicare will allow these modifiers on column one and column two codes to bypass the edit. More information is available in MLN MattersŪ article MM11168 linked here. [MM11168]
Modified: 4/4/2019
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2018 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM10405]
Modified: 4/4/2019
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
Modified: 4/3/2019
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 3.625 percent is in effect through June 19, 2019. [Publication 100-04, Chapter 1, Section 80.2.2]
Modified: 3/28/2019
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
Modified: 3/27/2019
This article is a reminder for all inpatient claim submitters about how to correctly submit the date of service on the claim.
Modified: 3/27/2019
This article is a reminder for all outpatient claim submitters about how to correctly submit the date of service on the claim.
Modified: 3/10/2019
To correct claims returned for beneficiary name and number mismatch, take the following action. [CR 7260]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.